OR Manager April 2023 - 7

PROCESS IMPROVEMENT
Lean visual management board huddle helps improve performance
BY JUDITH MATHIAS
visual management board is a
communication tool that provides
at-a-glance information
about current process performance to
help staff coordinate and guide their
daily work and monitor ongoing improvement
projects.
A
Perioperative staff at Harbor-UCLA
Medical Center in Torrance, California,
have a 20-minute weekly huddle at their
Lean-based visual management board,
which provides an avenue for them to:
* connect their work with performance
expectations
* view impact and progress
* identify where problems lie
* determine solutions
* demonstrate team appreciation
* celebrate successes.
" We keep this huddle
at 20 minutes because
that works out well for
all front-line staff, " says
Melia Barrow, BSN, RN,
CNOR, primary nurse,
RN II, cardiothoracic surgery,
Harbor-UCLA Medical
Center. " We invite
team members from the
anesthesia and surgery
Visual Management Board System: 20-minute Kaizen-improvement
Weekly Performance Meeting
Standardized Work
Title: Visual Management Board (VMB) System: 20-minute Kaizen-Improvement Weekly Performance Meeting
Date: June 1, 2022 Version: 13
Yellow Numbers on Board Indicate Standardized Work Step Number
Timekeeper should be assigned to time each section and time meeting for 20 mins. Red text indicate amount of time for each section.
1
30 secs
2
2 mins
2 mins
Key Performance
Indicators (KPIs)
3
4
30 secs
5
3 mins
8
6
3 mins
Out of Scope
Check
30 secs
10
6 mins
11
30 secs
12 Weekly Updates/Reminders
30 secs
9
30 secs
7
1 min
Source: Harbor-UCLA Medical Center. Used with permission.
Melia Barrow,
BSN, RN,
CNOR
departments, education, central sterile,
PACU, preop, and scheduling. "
Having a team member from each
department really encourages interprofessional
communication, says Barrow.
It's one time when all departments
come together to help each other over
hurdles they had been dealing with for
weeks or months.
A timekeeper is assigned to each
huddle to make sure staff stay on track
and don't get hung up on just one subject.
That person assigns a time to
each section on the board and holds up
a sign to let the group know if they are
going on too long. The timekeeper also
lets the group know when there are 5
minutes left at the end (sidebar, Visual
Management Board System).
The board may look complicated, but
is guided by purposeful visual cues lowww.ormanager.com
cated
on each section-current data,
improvement ideas, updates, and appreciations.
" It's really important that
we always end with the celebration and
appreciation of staff accomplishments, "
says Barrow, " because staff are integral
to making sure improvement projects
are successful. "
Key performance indicators
" The board is laid out so we can see
where we stand with each idea and project, "
says Barrow. The first section on
the board includes key performance indicators
(KPIs). " This is where we track
our data on a daily, weekly, and yearly
basis. We look at the trends and then
analyze them as a team. We see if our
goals are met or what barriers are preventing
them from being met. Then we
come up with ideas for moving forward, "
she says.
An example of a KPI would be first
case, on-time starts. The team begins
by deciding what their goal is. They
wanted it to be " patient in the room " at
7:30 am.
Looking at the data on the board,
the team can see that four rooms didn't
C:\Users\e613249\OneDrive - County of Los Angeles\Home Directory\Presentation\OR Manager October 2022\Board Photo - Board Leader - How to Run 20-min VMB Kaizen-Improvement Meetings.docx | Page 7
make the goal and what the reasons
were, such as no consent, needed
equipment not in the room, nurses
or surgeons not available, or regional
block being administered in preoperative
holding.
With this information, the team can
ask questions and come up with solutions
for getting blocks injected earlier
or having consents signed earlier.
Another KPI example would be urgent
case cycle time. " Because our facility
is a Level I trauma center, once an
urgent case is booked, we try to have
that patient in the OR within 24 hours, "
says Barrow. " If that isn't happening,
we are able to look through the data
and see why. It could be staffing or sterile
processing issues. The reasons are
all indicated in the data on the board. "
From there, the team discusses the
barriers for accomplishing the goal and
comes up with ideas going forward.
Standardized work
When the team members finish with the
KPI section, they go to the standardized
work observations section on the board.
This includes the current best thinking
OR Manager | April 2023
7
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OR Manager April 2023

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